In a world where food is available 24/7—from home delivered groceries to Uber Eats and DoorDash—it seems strange that so many of us walk around with a gnawing and persistent hunger.

You eat… yet you still feel hungry. You snack… but your cravings just don’t quit.

Why?

It turns out that hunger isn’t just about how much you eat—it’s more about what you eat. And one of the biggest problems may be that we’re eating a lot of the wrong foods, and not enough of the right ones.

If your body isn’t getting the nutrients it truly needs, it will keep sending hunger signals, no matter how many calories you consume. Let’s look at three common eating mistakes that leave people feeling unsatisfied—and what to do instead.

Here’s a fact that just about knocked my socks off. Nearly 1 in 2 adults in the U.S. are living with high blood pressure. That’s about 116 million people!

With numbers like that, it’s no surprise that blood pressure medications are handed out like candy. And while these drugs can be life-saving in the short term… they can turn against you in the long run. Plus, we often forget that the stronger a drug is, the more side effects will come with it.

And, sadly, if you’re taking 3 or more meds at the same time, drug interactions can increase the number of side effects that you experience.

Even worse, some of the most commonly prescribed blood pressure meds may be doing more harm than good — especially to your kidneys.

Let me break it down.

My 10-year-old grandson is a blur of energy. One day it’s soccer, the next it’s wrestling or swim team. He’s on the move from sunup to sundown — and somehow, never seems to tire.

That’s the beauty of being a kid. Their energy is practically limitless, powered by fresh cells, long telomeres, efficient mitochondria, and a flood of what scientists call “youth genes,” also known as sirtuins.

We adults? Not quite so lucky.

As we age, three major things happen inside our bodies that slow us down:

Have you ever heard the term “digital dementia”?

It was first introduced in 2012 by German neuroscientist Dr. Manfred Spitzer, who theorized that the growing use of digital technology could lead to memory loss and cognitive decline. It was a bold warning—and it sparked concern among many healthcare professionals, caregivers, and aging adults alike.

But now, more than a decade later, a major new study is turning that theory on its head.

I love pretty much anything with garlic in it… garlic stuffed olives, roasted garlic hummus, wild caught shrimp in an EVOO garlic sauce. It can even make foods I’m not very fond of taste good.

Spicing up my foods with garlic doesn’t just make them delicious. It makes them extremely healthy.

Plus, I like the history behind garlic.

As an Advanced Natural Wellness reader, you know that chronic inflammation is the driving force behind aging and age-related disease. It’s an underlying contributor to heart disease, diabetes, stroke, arthritis, non-alcoholic fatty liver, kidney disease, cancer, inflammatory bowel disease, Alzheimer’s disease, premature aging and so much more!

Unlike acute inflammation – the kind of inflammation you see when a wound turns hot, red and painful – chronic inflammation is invisible. You can’t see it or feel it. This long-term inflammatory state just silently eats away at your health and well-being.

For the most part, you can blame it on oxidative stress. This is something that occurs when unstable oxygen molecules known as free radicals build up in the cells and aren’t eliminated by the body. When this happens, it plays a crucial role in the development and persistence of inflammation.

When you get thirsty, there are so many choices that are tastier than water. Soda, sweetened juices, or even a beer might sound good.

And sure, all of these beverages do offer some hydration. But you have to consider all of the crap found in them. Things like sugar, corn syrup, sodium, artificial sweeteners and flavorings that will send you down to the path of bad health and early death.

The more important point, however, is that your body needs water to survive. Up to 60% of the adult body is made up of water. It’s found in every cell, every organ and every type of tissue in your body. Even the bones contain water.

We all have routines to clean and unclutter our homes. We sort out our closets and drop unused clothing at donation centers. Old storage containers and utensils in our kitchen cupboards and drawers are discarded. Tired rugs, sheets and curtains are replaced. Unwanted foods in the refrigerator are placed in the trash bin on garbage day.

But when is the last time you looked at the canned and packaged foods in your pantry and kitchen cabinets?

People tend to keep all sorts of food tucked away in their kitchen storage systems. Even if it’s foods they seldom, if ever, use. After all, nobody likes to waste good food!

Down here in South Florida, people stock up on a lot of unhealthy foods during hurricane season. They rob the grocery shelves of Spam, Vienna sausages, SpaghettiOs and Dinty Moore Beef Stew. But unless all food sources are cut off for the next month or two, will they ever even consider eating these purchases?

Just about everyone knows a high sodium diet is bad for blood pressure and, therefore, bad for heart health. That’s one of the key reasons people make the effort to avoid salty foods like chips, French fries, processed meats and pizza.

The problem is, there is a lot of added sodium in foods that don’t even taste salty, and others that simply sound healthy.

Surprisingly, bread is at the top of the high sodium food list. It doesn’t taste salty, but a single slice of bread can contain 100 – 200 mg of sodium.

Did you know that the older you are, the more likely you are to have type 2 diabetes?

It’s true. Nearly 30% of adults 65 and older are diabetic. And about another 50% have prediabetes. This means about eight out of every 10 seniors have blood sugar problems. Even worse, many older adults with these metabolic disorders don’t even know it!

One of the biggest problems with diabetes is that it causes serious damage to your body that can lead to heart disease, vision loss, kidney disease and nerve damage.

Sadly, people who don’t know they have the disease often find out about it after they’ve experienced a serious cardiovascular event, like a stroke or heart attack.

One thing I have seen over the years is that nearly everyone who has lost a parent to Alzheimer’s disease is terrified that they may develop the same condition as they age.

So it may be heartening to learn that the U.S. just approved the first blood test for Alzheimer’s. According to Yale Medicine, the test is expected to become available in laboratories starting this month, and will require a physician’s order.

It measures the ratio of two proteins in your blood – tau and amyloid. These are the two foremost indicators of the disease.

The question is, what should you do if the results of this test say that you or someone you love are headed toward dementia. Worse, what options do you have if the blood test indicates someone already has the disease.

When it comes to health, people place a lot of emphasis on their family history. They think “Oh, geez. Dad and grandpa both died so young that I probably don’t have much time left.”

Well I have some great news for you. It turns out that genetics don’t play nearly as big a role in your lifespan as previously thought.

In the largest analysis of its kind, researchers analyzed 54.43 million family trees from Ancestry.com – including birth and death dates for 406 million people. And what did they discover?

Hypothyroidism is one of those misunderstood conditions that is often either undiagnosed or misdiagnosed. That’s because the symptoms are so wide-ranging that it can be difficult to pinpoint.

It can cause fatigue, brain fog, anxiety, irritability, depression, forgetfulness, weight gain, hair loss and dry skin.

In women, many of these symptoms are similar to those that accompany menopause. Plus, untreated hypothyroidism can lead to depression. So it’s not uncommon for women to be sent away with a diagnosis of menopause or depression.

And because hypothyroidism is more common in women, many doctors completely overlook the possibility of low thyroid in men. But men can experience thyroid issues too, with the added symptoms of reduced sex drive, erectile dysfunction and low testosterone.

One of the supplements I recommend everyone take… every single day… is omega-3 fatty acids. Your body doesn’t produce them on its own, and it can’t function without them. So these essential oils have to come from dietary sources.

Unfortunately, the omega-3 fatty acids you need the most are the ones that come from fish. Specifically, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).

The reason this is unfortunate is because about 80% of people in the U.S. don’t eat the recommended 8 ounces of seafood per week.

I love fresh fruits and vegetables. They’re loaded with vitamins, minerals and antioxidants that are good for my health… and yours.

Eating fresh, plant-based foods is one of the easiest ways to prevent cancer. These foods protect against high blood pressure, heart disease, stroke and mental decline. They preserve your vision, prevent diabetes, keep you thin and support a healthy gut microbiota.

But there’s a problem. Here in the U.S., only one out of every 10 adults eat the recommended daily servings of fruits and vegetables. This means 90% of adults are eating less than the current guidelines of 1½ to 2 cups of fruit per day and 2 to 3 cups of vegetables.

One thing I notice when it comes to health concerns is that most people don’t pay nearly enough attention to their eyes.

This is a mistake.

Your eyesight is the key to independence. Once it starts to go, all sorts of things happen.

All berries are good for you, but fresh organic blueberries are, by far, one of my favorite snacks. The taste alone is enough to have me hooked on these tiny berries.

As small as blueberries are, you wouldn’t think they would pack much of a nutritional punch. But I’m getting a plethora of health benefits every time I eat them.

Blueberries are jam-packed with a potent class of antioxidants called anthocyanins. One thing anthocyanins are great for is improving insulin sensitivity. They work by protecting the pancreatic beta cells that produce insulin. They also enhance insulin sensitivity in muscle, fat, liver cells and other vital organs.

One of the biggest health threats here in the U.S. is the build-up of plaque in the arteries. It’s known as atherosclerosis, and it’s the underlying cause of about 50% of all deaths in westernized countries.

As plaque builds up in the walls of blood vessels, it causes them to narrow and can even block blood flow altogether. A completely blocked artery can lead to a heart attack or stroke.

But most of the damage happens when plaques rupture, which is what causes the majority of acute cardiovascular events. Some reports estimate that as many as 75% of heart attacks are caused by ruptured plaque.

There are a lot of reasons why you might feel gassy. Maybe you eat too fast and swallow too much air with each bite, or drink too many carbonated beverages. Certain foods might lead to gassiness, like beans, peas, cruciferous veggies and whole grains. Carbohydrates and sugars ferment into gas.

Any of these can lead to uncomfortable bloating and flatulence.

Other times, it’s harder to pinpoint a cause. And if you frequently experience gassiness, not knowing the source can be extremely frustrating. But that doesn’t mean there isn’t hope. In many cases, gas is a direct result of digestive issues.

Some of these are easier to address than others.

Even though gout is quite common, it’s one of the most misunderstood forms of inflammatory arthritis. Some people think only men develop the condition. But while the prevalence is higher in men, gout can also affect women. This is especially true after menopause.

Gout is caused by a build-up of uric acid in the body, a condition called hyperuricemia (pronounced hyper-yur-i-see-me-ya). This causes solid uric acid crystals to form in joints that results in excruciating pain.

The thing about gout is that the flare-ups occur on an irregular basis. They can happen suddenly once or twice a year. Maybe even less. In chronic cases, flare-ups will occur more frequently. And in either case the symptoms can last anywhere from a few days to a couple of weeks.

So it’s easy to think of gout as something of a painful mobility disorder during flare-ups… and forget all about it during periods of remission.

There are plenty of places to lay blame for today’s epidemic of obesity and diabetes. And most of them boil down to lifestyle choices.

However, there is one thing that I believe is greatly adding fuel to the problem. It’s a common decision that millions of people make every day in the name of good health.

It’s the conscious choice to opt for artificially sweetened foods and beverages.

Now, a lot of people don’t believe me when I share this information with them. And I completely understand their disbelief. After all, marketers for these fake sugars have done a great job of making it sound like they are the cure-all for obesity and metabolic issues.

Yet, despite all of these marketing tactics, artificial sweeteners don’t aid weight loss. Nor do they protect against diabetes. Rather, they actually contribute to a larger waistline, increased weight gain and a higher incidence of obesity.

Mushrooms are a staple in my kitchen. I toss them in my omelets and frittatas, put them in soups, stews and stir fries, add them to salads and veggie wraps, and use them as a topping on meats and fish.

As it turns out, I’m the “odd man out.”

The average American only eats about four pounds of mushrooms – per person – in a given year. But me? I probably eat somewhere between a half pound and a full pound each week or so.

Now that the weather is warming up, blooming trees and shrubs are releasing pollen into the air. And you know what that means…

Spring allergy season has officially arrived in many parts of the U.S.

If it seems like your allergies started early this year, you’re not alone. According to the Asthma and Allergy Foundation of America, you can blame it on climate change.

Growing season – which is when high levels of pollen are released – is starting earlier each year, and lasting longer. This creates a longer and more intense spring allergy season.

People over in Japan often eat a traditional cucumber salad called sunomono. This dish is really easy to make. It’s simply sliced cucumbers in rice vinegar, seasoned with a little soy sauce and sugar, and topped with sesame seeds. Other items, like seafood, seaweed or tomatoes, can be added as desired.

But there is something very interesting about this dish. Researchers in Japan found that men who habitually eat it have significantly lower blood pressure compared to those who don’t eat it regularly.

What is the big blood pressure lowering secret behind sunomono?

Despite dozens of trials, the idea that men go through male menopause – or “manopause” – isn’t totally accepted in the medical community. It’s not even accepted by a lot of men.

Does that make it any less real?

In women, menopause is basically ovarian failure. The levels of female hormones produced by the ovaries plunge, her menses stop, and she is no longer fertile.

We often hear about the negative health consequences of too much sodium in our diets.

 It raises blood pressure, contributes to plaque formation in the arteries and raises your risk of heart attack or stroke. It is a risk factor for type 2 diabetes, can trigger kidney stones, aggravates joints and creates an inflammatory environment in the body.

It’s just not good for you.

How many times have you heard that vitamins are a waste of money and you’re just making expensive urine, throwing money down the drain if you purchase them?

But the fact is, vitamins are needed to fill in nutritional gaps that, if not addressed, could lead to some very serious health concerns.

You see, these days it’s virtually impossible to get all of the vitamins and minerals you need through diet alone.

Over 100 years ago, William Howard Taft was the heaviest President to ever hold office in the U.S. Weighing in at more than 340 pounds he was what we call morbidly obese. At 275 pounds, Grover Cleveland was the second-heaviest President.

But it’s interesting to note that neither of these men developed adult-onset diabetes. In fact, most morbidly obese people back in those days never became diabetic.

The reason is oddly simple. Prior to the mid-1900s, people didn’t encounter all of the toxins that are so prevalent in our society today. Many researchers now call these toxins diabetogens, because they have such a profound effect on blood sugar control and weight.

Back pain is the most common form of pain in the U.S. As a matter of fact, an estimated 75% to 85% of Americans experience some form of back pain during their lives.

The good news is that most cases of back pain are temporary. About nine times out of ten pain improves without surgery. The bad news is that, during a flare-up, back pain can be excruciating and severely restrict daily activities. And there are a lot of reasons for it.

In most short-term cases back pain is likely caused by muscle strain. This can be caused by numerous reasons; lifting something heavy, repetitive movements, sleeping in the wrong position. You twist the wrong way, sit in the same position for too long or bend too far.

A lot of people get in a bad mood when they’re hungry. They can throw a temper tantrum and lash out at the simplest little thing.

These days there is a name for it. We call it being “hangry.”

But is it really just a mental state? A bad mood? A feeling of irritation or annoyance?

I wouldn’t call it any of those things. Instead, I would call it a “hormonal neurotransmitter warning” state.

As we age, we reach the point where old bone breaks down faster than it’s being replaced. The result is osteoporosis… weak, brittle bones that break and fracture easily. And it’s not just women who are affected.

Around one in three men over the age of 50 already have low bone mass density. And by age 75, their risk of a hip fracture increases rapidly.

What can you do about it?

Last week you learned how certain medications can affect your blood press pressure.

Well, that’s the thing about both prescription and over-the-counter drugs…

There are issues with all of them. Not a single one of them is 100% safe. They interact with other meds you’re taking. None of them actually cure disease. And, for the most part, the minute you stop taking a medication, whatever symptoms and complications you were experiencing will return.

You’ve got your statins. Drugs to lower blood sugar and improve insulin sensitivity. Then there are the meds for pain, depression, anxiety and countless other conditions. There’s pretty much a drug for anything and everything.

You probably already know that processed meat is bad for you. We’ve known for years and years that even a small amount on a regular basis is linked with a higher risk of cardiovascular disease, type 2 diabetes and cancer – especially colon cancer.

Now, a new Lancet study involving researchers from prestigious schools such as Mass General Brigham, Harvard T.H. Chan School of Public Health, MIT and Harvard have established a link between processed meat and dementia.

Sometimes people with high blood pressure do everything right. They start exercising, eat a healthier diet and monitor their sodium intake. But then they find that their blood pressure still isn’t budging.

It can be really frustrating when someone with high blood pressure can’t get it under control, especially if they’re also taking blood pressure meds.

Well, it turns out that a lot of people with high blood pressure are unintentionally taking other drugs that make it worse. And you won’t believe how easy it is to fall down this rabbit hole.

The biggest fear for women who have survived breast cancer is that it will come back. This is a threat that survivors of all types of cancer face every day.

Sadly, there is no silver bullet to prevent recurrence. However, there are things you can do in your life to change the environment where the cancer grew in the first place and help lower your risk. You probably already know that weight loss, toxin avoidance, stress reduction, plenty of physical activity, and a healthy diet can all go a long way toward helping you remain cancer free.

But you may not be aware of a few specific foods that can have a big impact on your life when it comes to remaining cancer free.

I know people who have tried to go on a raw food diet. And I realize how attractive the concept is. It sounds so “clean” to get living food enzymes and nutrients from raw food. And it is!

Raw fruits, veggies, nuts and seeds are loaded with digestive enzymes and antioxidants. When you eat raw, organic vegetables instead of those that are cooked, you get more firm fiber, which is going to make your gut microbiome healthier.

This makes a raw diet especially appealing if you need to lose weight, since fiber can help you feel full longer so that you eat less. And a more balanced microbiome is great for your health.

I’ve been limiting my intake of meat for quite a while now. But I still enjoy it on occasion.

My absolute favorite is grass-fed New Zealand lamb. I pierce the top of the meat with a series of holes and fill each opening with a clove of garlic. Then, I cover the entire thing with organic ketchup to keep it moist and pop it into the oven.

It’s absolutely delicious. The garlic caramelizes, the ketchup keeps it moist and gives it a little shell. When you slice into it, the meat’s soft, rich, delicious and moist.

As tasty as it is, you probably wonder why I don’t eat it more often.

We hear a lot of bad news about carbohydrates. So some people try to avoid carbohydrate foods altogether. They’re afraid of “carbotoxicity.” This is the idea that eating any type of carbohydrate will contribute to chronic disease.

Well, that’s a misconception.

It’s not about whether you eat carbs or not. It’s more about whether you’re eating the right carbs or the wrong carbs.

When you eat the right kind of carbs – the ones that feed your gut bacteria and help you maintain a healthy gut microbiome – you don’t need to worry. They aren’t in the least bit toxic.

Eating whole grain breads, cereals and muffins sounds great. They have to be a lot healthier than all of those refined grains sitting on the store shelves, right?

Well guess what. A lot of those whole grain foods are only telling half-truths.

Take the phrase “Made with Whole Grains.” What does that really mean?

Well, it means that there is some whole grain in the product, but you have no idea how much. It could be the tiniest amount – just enough to be able to say it on the label. In reality, the product is likely to be mostly refined flour, which doesn’t have either the fiber or the nutrition you’re looking for from a whole grain.

It wasn’t that long ago that red light therapy was something you could only find at dermatologist offices and luxury spas.

The claims were that it could make skin firmer and reduce fine lines to make you look younger. It could fight off eczema, psoriasis, rosacea and other skin problems. It could regenerate and repair aging skin.

Needless to say, there were a lot of skeptics. It sounds like snake oil, right?

But keep this in mind. Light affects our bodies more than most people realize.

When I think of the term “weekend warriors,” I immediately imagine two groups of people gathering in a large field on a Saturday morning. Somebody blows a horn or whistle, and everyone begins to throw rocks, stones and arrows at each other.

Then, when Sunday evening rolls around, the group that has the most people still standing is declared the winning team. The crowd roars…

Or not.

We can probably blame this image on too much TV when I was a kid.  But it has nothing to do with what being a weekend warrior means in today’s world.

It happens to everyone. You sit too long in one position and a leg falls asleep. Lean on your elbow for a while and your lower arm and hand go numb. As the feeling starts to return, you feel like someone is pricking you with a couple of hundred tiny needles.

It’s uncomfortable for a few minutes, then it disappears altogether.

But what does it mean when it doesn’t go away? What does it mean if it’s a frequent occurrence… or if those weird sensations are there all of the time?

Today’s modern world is full of stressors. We are bombarded with stressful situations all day long, day after day, month after month.

Money woes, problems at work, health concerns, the death of a loved one and other troubling personal events top the list. But it doesn’t stop there. Headlines are riddled with news of wars, random shootings, natural disasters, and other events that often lead to mass casualties. This just adds to our stress levels.

But our bodies aren’t built to be stressed out all of the time. All of these stressors produce a “fight or flight” response, a built-in reaction that ensures our survival.

The problem is, all of that stress isn’t just affecting your mental and emotional well-being.

People think arthritis only happens in old people. Ask any 40-year-old with arthritis, and they’ll tell you just how untrue that is. In fact, more than half of adults with arthritis are between the ages of 18 and 64.

The truth is that, even though we often call arthritis an age-related disease, it’s not actually caused by old age. Chronic inflammation, obesity, joint injury, diabetes, heart disease and all sorts of factors come in to play. It’s not just one thing. And it doesn’t care how old you are. You could be 15, 40, 60 or 90. You’re not immune.

So while a lot of people believe the “old-age” myth of arthritis, it’s just not true.

And there are a lot of other misconceptions about arthritis that sound pretty believable.

Irritable bowel syndrome is one of those conditions that remain underdiagnosed in the U.S. According to the American College of Gastroenterology, it’s estimated that about half of the people affected by it have not been diagnosed.

That’s because it’s a tricky condition. It generally comes with abdominal pain and changes in bowel habits. But those bowel habits may show up as diarrhea… or constipation… or a mix of both. Some patients will have more pain than others, and it may or may not be accompanied with chronic or occasional bloating.

So it can be difficult to determine whether these patients have irritable bowel syndrome, or if something else is going on.

Now that we’re in the fall season, temperatures are dropping around the U.S. Even down here where I live in South Florida, we’ve finally been able to say goodbye to those sweltering days of summer.

And in the upcoming months, we’ll start seeing snow flurries in the upper states.

Well, while unpacking your winter gear and analyzing what you need to purchase or update, don’t forget to add a pair of winter sunglasses to your list!

I know. You probably think of sunglasses as summer wear. But they aren’t just for sunny summer days. And they aren’t just to keep you from squinting in the sunlight.

A lot of people tend to think snoring and sleep apnea are the same thing. They aren’t.

When you snore, the soft tissue in your neck relaxes and vibrates when you draw in air. That vibration is the noise of snoring. 

Not everyone who snores has sleep apnea. But most people with sleep apnea do tend to snore.

The difference is going to be in how you feel when you wake up in the morning. Normal snoring doesn’t really disturb your sleep, so you should generally wake up feeling pretty refreshed.

When talking about Alzheimer’s, medical professionals often refer to amyloid plaques. The common belief is that these are the underlying cause of the disease – and that if you get rid of them, you’ll be cured.

But that theory has been proven wrong, over and over again.

First off, every time they’ve developed a drug to reduce levels of these proteins, it hasn’t work. Instead, these experimental drugs seem to make matters worse.

The Incredible Shrinking Man isn’t just the title of an old science fiction movie. It’s also a reality. We shrink as we age.

Starting at about age 40, most people tend to lose about a quarter to a half inch of height each decade.

Part of the reason is because of the gel-like cushions between your vertebrae. They support your posture and act as shock absorbers. But over time, they gradually compress and flatten. So the spaces between your vertebrae get smaller, which basically makes your spinal column shorter. But shrinking too quickly or too much is not normal. It’s not a symptom of old age.

When it comes to cholesterol, mainstream medicine has it all wrong. LDL cholesterol isn’t the “bad guy”. In fact, it’s not even cholesterol. Neither is HDL.

People don’t get that.

You ask them what their cholesterol is and they say “Oh, my HDL is this or my LDL is that.” Those things are not cholesterol. They are proteins – either low-density lipoproteins to carry cholesterol to the arteries or high-density lipoproteins that carry cholesterol away from the arteries and back to the liver to be recycled.

And let me be clear on one thing. Your body makes 85% or so of the cholesterol from your liver. Because your body needs it!

Did you know that being over 65 years of age is a risk factor for vitamin B12 deficiency?

It’s true. But most mainstream doctors don’t really know how to diagnose it. That’s because they receive very little training on nutrition – generally less than 20 hours of nutrition instruction during their entire time at medical school.

It’s one reason I trained in functional medicine – to learn how food and nutrition affect all systems of the body. And it sure comes in handy when it comes diagnosing vitamin B12 deficiency.

The thing about this type of deficiency is that it mimics disorders that often accompany “old age.”

Back in 1931 doctor Otto Warburg, M.D. won the Nobel Prize in medicine. He was a German Jew in pre-World War II Nazi Germany. So it must have been a difficult decision to award it to him. But they had to, because he was the first to recognize the metabolism of cancer.

He discovered that cancer can’t grow and metastasize in two different conditions.

One was a high oxygen tension environment, like that of a hyperbaric chamber. But hyperbaric oxygen therapy (HBOT) wasn’t really available back then.

Dead butt syndrome. It sounds like the punch line of a bad joke. In fact, you’re probably already rolling your eyes and thinking, “Come on Doc, give me a break! There’s no such thing.”

Actually, there is… kind of.

Some experts are calling it gluteal amnesia. Others call it sleepy glutes. But “dead butt syndrome” makes for a great headline, right?

If you have varicose veins, you know how unattractive they can make you feel. These dark, twisted and bulging veins aren’t a pretty sight.

Of course, the cosmetics industry sees this as a beauty issue. They are constantly peddling a new cream, ointment or mud pack that promises to erase those unsightly veins forever.

Well, varicose veins are not a cosmetic concern. They are a health issue. No beauty treatment in the world is going to get rid of those gnarled veins, let alone treat the underlying cause of them.

With all we know about antibiotic resistance these days, you would think the use of these drugs would be more closely monitored.

Well, a May 2024 study indicates otherwise. The researchers tracked more than 152 million visits to emergency rooms that resulted in one or more antibiotic prescriptions and compared them against diagnosis codes.

Their analysis revealed that 54% of the visits resulted in inappropriate antibiotic prescribing with a plausible antibiotic indication, while 46% resulted in inappropriate prescribing without a plausible indication.

Dieting doesn’t work the same for everyone. Some people swear that Keto is the best. Others will tell you vegan is the way to go. There’s Pegan, paleo, Atkins or The Zone. You name it, and it worked for somebody.

We are all so different that it makes perfect sense that there is not a single, one-size-fits-all weight loss plan for everyone!

Some people need more or less protein in their diets. Some do well with more fat or fewer carbs. And if you have the C677T gene mutation where you need methylated B12 and folate to keep you healthy, that’s something else entirely.

Meeting our nutritional goals these days can be tough, even when we eat a relatively healthy diet.

That’s because modern day agricultural practices now dominate our natural food supply; our fruits, vegetables and other plant-based foods. And it has stripped so many of these foods of their high nutrient profiles.

How did this happen?

Chronic, low level inflammation is like a plague these days.

Nearly everyone has it, nobody wants it, and it is the underlying cause of nearly all of today’s biggest health threats. I’m talking about heart disease, arthritis, diabetes, Alzheimer’s, cancer and more.

But it’s not always unhealthy lifestyle choices that promote this problem. Sometimes my patients make seemingly healthy decisions that lead them astray.

We’ve known about microplastics for a while. We hear about how prevalent they are in water and other products sold or stored in plastic bottles, storage containers and wraps.

But they are found in other places, too. They are in your tap water, fish and shellfish, and meat products produced from commercial livestock.

There is pretty much no way to avoid them these days, and that’s a problem.

Up until around 50 years ago, we didn’t know much of anything about omega-3 fatty acids. The big breakthrough didn’t come until 1971. That’s when researchers compared the eating patterns of Eskimos and Danish people up in Greenland.

What they learned is that the Eskimos had much lower rates of heart disease and a complete absence of diabetes compared to the Danish people. The Eskimos also had significantly lower concentrations of total lipids, cholesterol and triglycerides.

This brought the researchers to the realization that heart disease may not be as genetic as they previously believed. And they were right.

Between all of the daily tasks I have to complete using my computer, tablet and phone, my eyes often feel like they are taking a beating. By the end of the day, it is not uncommon for my eyes to feel dry, gritty and itchy.

This is pretty common for anyone who uses electronic devices on a regular basis, or does a lot of fine-print work. But these efforts alone may not necessarily be the root cause of your dry eye symptoms.

There is another cause that we really don’t hear much about. It’s called meibomian gland dysfunction, or MGD.

A lot of people have this disorder and don’t even realize it. That’s because it is seriously under-diagnosed.

In the August 19, 2024 issue of Advanced Natural Wellness, you learned some surprising facts about age-related muscle wasting, or sarcopenia.

You don’t have to be old to start experience symptoms; and you might not even look like you are losing strength and muscle mass.

To top it off, we’ve been raised with the idea that, once we reach a certain age, we should retire. Just slow down and live the good life.

Bad idea.

Heartburn can be a scary thing. That’s because it feels like the pain and burning is coming from your heart. Even the name, “heartburn,” suggests that it is heart-related.

Thankfully, that is not the case. Rather, the sensation of heartburn occurs when stomach acids back up into your esophagus. This is known as acid reflux, or GERD.

It’s surprising how many people experience symptoms on a regular basis.

It’s no secret that dental plaque, oral bacteria and gum disease can affect your heart health. For many years now there has been a link between what’s happening in your mouth and your risk of cardiovascular disease.

It all starts off with a buildup of dental plaque. When the plaque and bacteria escape into your bloodstream, it damages blood vessels, contributes to the buildup of arterial plaque and can even result in blood clots.

Worse, gum disease is a source of chronic inflammation that spreads throughout your body. If you’ve been keeping up with my news articles, you know inflammation is a key factor in heart disease.

What you may not realize is the role your teeth and gums might play in other areas of your health.

As we humans grow older, we tend to lose lean muscle mass and strength. The medical name for it is sarcopenia.

It brings to mind images of those frail, thin, older adults that we often see at the grocery store… or the ones tottering between family members as they are guided to a table in a restaurant.

Sure, these seniors likely meet the criteria – you can tell just by looking at them that they are suffering from age-related muscle loss. But they aren’t the only ones.

The fact of the matter is that you don’t have to be old to suffer from muscle wasting.

Sex does a lot of good things for people.

Everyone needs to have the feeling that happens during climax – that dopamine release. This pleasure chemical is responsible for the euphoria and satisfaction that floods through the body during the “big event.”

But that wonderful feeling isn’t the only thing that happens.

As we grow older, a strange thing happens to our arteries. They start stiffening up. The older we get, the stiffer they seem to become.

And unlike so many common health issues today, age is by far the major force behind this phenomenon. But that doesn’t mean there aren’t other contributing factors that are directly under your control.

In particular, high blood pressure stresses the walls of the arteries and damages the flexible fibers (elastin) responsible for arterial elasticity. Diabetes, obesity and chronic inflammation are also associated with stiffer arteries.

There is a lot of confusion about prebiotics and probiotics. And then there is another type “biotic” altogether, called postbiotics, that most people don’t even know about.

What are they? Where do they come from? How are they different from one another?

Let’s start with the basics.

Probiotics are live bacteria that add to the population of healthy microbes living in your gut. And you know how important a healthy gut microbiome is!

The gut is your prime source of immunity against ANY type of infection – viral, bacterial, fungal or whatever happens to invade your body.

The microbes in your gut aren’t just a bunch of bacteria that help break down and digest the foods you eat. They also “talk” to your brain.

This phenomenon is called the microbiota gut-brain axis.

Basically, it’s the ability your gut bacteria have to activate signals to your brain. This means your brain tunes into everything that’s happening in your digestive tract. And if you have the wrong mix of microbes in your gut, it could be skewing what happens in your brain.

This relationship is much stronger than researchers believed in the past. In fact, a June 2024 study published in Nature Mental Health finds that the gut microbiome may play a very distinct role in people who are highly resilient in the face of stressful events.

Patients with hair that is unhealthy or thinning often ask me if they should take a “hair supplement.” Some of these men and women have already tried these types of supplements with little success. Others swear by them.

Well, I’m going to give it to you straight.

There are a lot of reasons for hair loss. Stress, illness, medications and other issues are often the cause.

On the other hand, nutritional deficiencies often play a major role in hair loss.

The older you get, the more protein you need.

And it’s not just about maintaining muscle strength. Protein also helps build strong bones, skin and hair. It aids digestion and has an important role in the regulation of hormones.

So protein is definitely an important part of your diet. But there is a problem…

You’ve got a sharp ache in your lower back that you’ve never had before, so you head to the doc.

He pokes and prods, then pats you on the arm and says, “You’re just getting older. You can expect to start feeling more unusual aches and pains than you used to.”

Don’t you just want to punch him or her?

Just because you’re getting older, it doesn’t mean you’re stupid! You know there is something wrong with your body, but these guys make you feel like a little kid for mentioning it.

There’s an old joke that goes something like this…

The patient says, “Hey, Doc! It hurts whenever I do this.”

The doctor replies. “Then stop doing that!”

This little comedy routine has absolutely no relevance to real life, yet many people take it to heart.

It is something that has plagued me during my entire career, especially when the general complaint is that a patient’s knees, hips or back hurt when they walk.

What do these patients do? They often stop walking unless absolutely necessary!

Just a few days ago we talked about the dangers of polypharmacy – taking five or more medications on a regular basis.

As a quick follow-up to that, I want to alert you about how high summer temperatures – which are affecting most of the U.S. right now – can influence the way certain medications work in the body.

You see, some commonly used medications can make you more susceptible to heat-related illness. They disrupt the regulation of your body’s core temperature; something known as thermoregulation.

In the June 3rd issue of Advanced Natural Wellness you learned about four types of medications that are dangerous for aging adults. The list included non-steroidal anti-inflammatory drugs (NSAIDs), anticholinergic medications, acid reducers and muscle relaxers.

But there is a much larger problem when it comes to medicating older patients.

It’s something called polypharmacy, which basically means “the regular use of five or more medications at the same time.”

Whenever I am a couple of weeks late changing the HEPA filters in my ionizers, they become especially filthy. They come out covered in a black, grimy fuzz and are thoroughly disgusting.

Where the heck does this stuff come from?

In my case, it’s probably because I live in a flight path. Every day when I walk outside, my white car is covered in soot from jet fuel. I assume it gets in my house too. That would explain the condition of those filters.

The scary part is that, without my filters, this crap would be going into my lungs. And that certainly wouldn’t be good.

People spend a lot of time thinking about food, cooking food and eating food. But they very seldom put very much emphasis on chewing their food.

Just think about how long it takes to create perfectly smoked baby-back ribs or beef brisket for summer holidays.

Nearly all day, right?

But how soon is it over once you sit down to eat? Pretty quickly, right?

When I was a teenager, AM radio stations blasted the summer season over the airwaves with regular frequency.

“It’s summertime summertime sum sum summertime.”

I loved it!

School was out. I had a full three or four months of freedom. (And rest assured, I always made the most of it.)

Even though I live in South Florida now, where seasons never seem to change, I still hold precious memories of those summer days. They make me smile.

Ask anybody you know what they think the biggest threat to their heart health is. I’ll bet the large majority of them will say high cholesterol.

This makes statin drugs sound appealing; and makes a lot of people extremely willing to take them.

And sure, statins really DO decrease LDL cholesterol.

But there are probably a lot of things you don’t know about these cholesterol-lowering drugs; and a lot of things you may not realize about cholesterol itself.

I remember my first colonoscopy clearly. I laid down on the table to get prepped for the procedure…

Then, I opened my eyes, looked at the IV nurse, and said, “Okay, I’m ready.” She just looked down at me and said, “Honey, you’re done!”

Wow! That was quick and easy.

Thinking back, it really wasn’t that scary, but I can understand why so many of my patients feel some nerves.

The safety of consuming artificial sweeteners has taken a BIG hit this year. I’ve warned you about them in the past.

Despite marketing claims, they contribute to a larger waistline and the development of metabolic disorders like diabetes.

Many artificial sweeteners are neurotoxins. They over stimulate neuron receptors which, over time, destroys brain cells.

They can cause headaches, insomnia, seizures and other neurological side effects. This can also lead to serious health problems such as multiple sclerosis, Alzheimer’s disease and Parkinson’s disease.

Do you have a hankering for something salty or fatty? Are you yearning for something sugary?

It’s easy enough to grab a bag of chips, a slice of pizza, soda or candy bar to satisfy whatever desire you have. And to tell the truth, an occasional treat is no cause for concern. Almost everyone has food cravings now and then.

But what happens if you find yourself craving one or more of these types of food on a daily basis?

Everybody seems to think whole grains are the best high fiber foods to get their bowels moving. They eat them constantly and hope they will instantly relieve the constipation that often plagues adults, both young and old.

So these foods fly off the racks of grocer’s shelves, whether they are in the form of bread, bagels, breakfast bars or cereals. Everyone wants more fiber in the form of whole grains!

What most people don’t realize is that the definition of a “whole grain” has nothing to do with fiber content. In fact, many whole grain products contain very little fiber.

What’s the deal with the high amounts of caffeine in coffee? Is it good for you, or is it bad for you?

The consensus is not cut and dried, and I will explain why in a moment.

First, let me share some of the great things that can happen when you drink a cup or two of coffee each day.

Fats are one of the most misunderstood food groups when it comes to health and weight. These days many people think anything that isn’t labelled “no fat” or “low fat” is unhealthy and fattening.

Nuts are a great example of this.

Study after study shows that people aren’t eating the recommended 1- to 1.5-ounces of nuts daily. In fact, the large majority of people aren’t eating any nuts at all!

And do you know why people are avoiding nuts?

Sushi isn’t one of my “go-to” foods, but I get the appeal.

Fish is a low-calorie source of protein and packed with healthy omega-3 fats that promote good health. Roll it together with rice, seaweed and veggies, and you’ve got your proteins, fats and carbs all prepared in convenient bite sized pieces.

It’s a light and refreshing meal that some people would love to eat every day of the week.

At last count, a whopping 85% of U.S. adults over the age of 59 reported taking prescription drugs. And about a third of those in their 60’s and 70’s said they were taking five or more prescription meds on a regular basis.

Mix that with all of the over-the-counter (OTC) pills older adults take these days, and the potential consequences are just horrible!

You see, there’s something most people don’t know about prescription drugs.

On March 19, 2024, you learned the difference between cage-free, free range, organic and pastured eggs.

Since then, I’ve received several emails asking me what the REAL SITUATION with eggs is. Are they truly safe? Can I eat them without worry? Why do some experts say they are part of a healthy diet – and others say they are dangerous?

Let’s just say that, for the past 40 or 50 years, eggs have gotten a bad rap. The original advice to avoid them was based on flawed and biased data.

Back in the 1960’s and 70’s, people had no idea what to do to prevent heart disease.

But these days?

Thanks to the Internet, pretty much everyone knows the secret… Don’t smoke, eat healthy foods, get regular physical activity, avoid processed foods, slack off on hard alcohol, and watch your sodium intake.

There are even still a few myths hanging around that people adhere to, like the misguided idea that egg yellows are bad for you (they’re not)! Or that margarine is healthier for your heart than butter (it’s not)!

When I was a kid, I wasn’t allowed to leave the table until I ate all of my vegetables. “They’re good for you!” my Mom would exclaim.

The problem was, she didn’t know how to cook them.

Broccoli and cauliflower were soggy masses of florets that had been boiled to death. Asparagus turned into a slimy mess. Carrots lost every bit of their crunch…and green beans from a can were always dreaded.

There wasn’t an ounce of flavor in any of them. (Needless to say, I wasn’t a vegetable-loving kid.)

Everyone loves the idea of eating a mostly plant-based diet. It’s healthy. It’s wholesome. It’s just downright good for you!

Whole, plant-based foods are great for your heart, blood pressure, metabolism and memory. They protect against age-related health conditions, and can work wonders for your waistline.

But there is a huge difference between the health effects of fresh whole foods that go from the farm to your table, and those that are ultra-processed for use in plant-based meat alternatives.

What kind of mouthwash do you use?

There are so many choices these days and the claims are hard to know which one to choose. All of them promise to give you sweet-smelling breath. Some state that they’ll strengthen enamel. Others guarantee to whiten your teeth or pledge to kill germs that cause gum disease.

Your mouth is teeming with bacteria, so this may sound like a good thing. Swish around a little mouthwash to kill all of those wicked microbes and you’ll have a cleaner, healthier and fresher-smelling mouth, right?

People have so many health concerns as they age. They worry about their hearts, memory, eyesight, weight and so much more.

But when is the last time you wondered how your kidneys were doing? You really want to keep these 5-inch-long bean-shaped filters of your blood as happy as they can be.

But kidney function decreases as we get older. And by the time we’re in our 60’s, kidney problems are pretty common. The problem is, nine out of ten adults with chronic kidney disease (CKD) don’t even know they have it! That means most people with poorly functioning kidneys are walking around the world unaware.

A few weeks ago, I mentioned that vitamin D is necessary to regulate the absorption of calcium in your body to help keep your bones strong and healthy.

But Big Pharma is trying to change the dialogue about vitamin D.

One thing we are seeing are more and more reports stating that routine vitamin D testing is unnecessary. The reason?

Well, why test for it when people can buy vitamin D and take it on their own, regardless of their blood levels?

Nearly all men will experience an enlarged prostate (benign prostatic hyperplasia, or BPH) in their lives. At some point, they will find themselves making constant trips to the bathroom, especially at night. And it may seem that urgency is required… but when you stand over the toilet you may only be able to dribble.

You see, a normal sized prostate is about the size of a golf ball. But over the years, it can become as large as a tennis ball. When this happens, it presses down on your urethra like a vice. This can cause all sorts of troubles when it comes to passing fluids from your bladder through to the toilet bowl.

As a result, up to 50% of men over the age of 50 – and up to 80% of men over the age of 80 – will experience urinary tract symptoms cause by BPH.

Do you ever experience a weird flutter in your chest? Maybe your heartbeat feels like it skips a beat every now and then. Sometimes it might seem like it’s pounding or racing. It could even feel like your heart just performed a flip-flop.

If any of these happen occasionally and is a short-lived sensation, it’s generally not something you have to worry about. In fact, most heart palpitations are harmless, and can be caused by any number of reasons.

Stress and anxiety are at the top of the list. Among other things, the emotional distress associated with these conditions alter brain activity in a way that makes the heart more susceptible to electrical instability and palpitations.

When I go to bed at night, I often use a sound app on my phone to help me sleep. I like to listen to cricket noises or rain. Anything from nature works. But sometimes I just want white noise. On those nights, I play an air conditioner background noise. It blocks out most other ambient noises and it’s constant.

But you would be surprised at the effect certain sounds can have on your health, and how sound is gaining ground for its role in relieving stress, soothing anxiety and positively shifting brain chemistry. In fact, we actually had two speakers at U.Miami’s 2022 “Planetary Health to Human Health” conference who spoke on the topic.

Sound has been used to soothe and stimulate since the beginning of time. For example, the unique sounds of the Andean panpipes, or pan flutes, have been around for thousands of years. Originally, they were made from bone and clay, but now they use bamboo.

Milk. It does a body good.

I agree with this statement… as long as it’s intended for babies who are suckling at their mother’s breasts.

For adults? Not so much.

When I first started practicing medicine, I didn’t see a lot of liver disease. When I did run across a case, it usually involved someone who was a heavy drinker. There really weren’t a lot of surprises.

Sadly, this is no longer true. We are seeing more and more cases of non-alcoholic fatty liver disease (NAFLD).  In the past couple of decades, I’ve seen a huge uptick in this silent killer in my own practice. And people who don’t drink alcohol are very surprised when they get a fatty liver diagnosis.

NAFLD occurs when too much fat accumulates in the liver. Eventually, that fat buildup begins to affect liver function and damage the cells and tissue.

And here is a sobering statistic…

Back in the 1980’s, the airwaves were filled with a song that wanted everyone to walk like an Egyptian. I never really understood the song itself, but I have to admit. All of the moves and grooves that went with it were great forms of physical activity.

Anyone who wanted to participate had to raise their hands, dip their knees and shake their hips. So it was a fun and exciting way to get people moving!

Now I have a new move for you. It’s called Nordic walking.

Back in the 1990’s and early 2000’s, men diagnosed with low-risk prostate cancer thought it was a death sentence. So they often opted to undergo immediate surgery or radiation treatments, which can both result in serious, lifelong side effects.

These days, however, men are increasingly choosing not to undergo immediate treatment. Instead, they are opting for active surveillance – holding off on treatment until there are signs the cancer may be advancing.

This is a great choice because, over the years, we’ve learned that most men diagnosed with prostate cancer don’t die from it. As a matter of fact, they are more likely to succumb to cardiovascular disease, COPD or Alzheimer’s disease.

In the last issue of Advanced Natural Wellness, you learned how ultra-processed foods can destroy your health. On the other hand, eating a nutrient-rich diet is one of the best things you can do to increase your chances of a long and healthy life.

But trying to figure out what to eat can be overwhelming. In fact, patients often ask me if there are certain foods they should be eating more of.

This is a great question. And I’ll share with you the same answer I give my patients.

I hate walking into the grocery store.

Most of the shelves are nothing but row after row of canned, processed, packaged, sweetened, and genetically modified foods filled with all sorts of things your body doesn’t know what to do with.

These foods consist of sugars, fats, oils, sodium and all sorts of additives guaranteed to fatten you up while leaving you sick, weak and hungry. You’ve got your flavor enhancers, bulking agents, emulsifiers, artificial sweeteners, color stabilizers, anti-caking agents, thickening agents and more.

A large part of the carbohydrates in your diet come from starches. Potatoes, breads, pasta and rice all fall into this category.

I’m not a fan of these types of starchy foods. That’s because, when you eat too many of them, they can drive your blood sugar up and lead to metabolic disorders. So these are some of the foods I consistently advise my patients to cut back on.

However, there is a certain type of starch that has garnered more and more interest over the years. It’s called “resistant starch.” And it falls into an unusual category. Along-side being a starch, it’s also a highly-fermentable insoluble fiber.

We all like to think that there is a single, correctable cause of disease. But the fact is, when things go wrong in the body, it’s never just one thing. And often-times, some of the things that negatively affect your health don’t even seem to have anything to do with the health condition in question.

Cognitive decline, dementia and Alzheimer’s disease are perfect examples.

Sure, it makes sense that the less we use our brains, the greater the likelihood we will experience cognitive issues. Even the idea that low physical activity reduces brain function makes sense. It is very easy to imagine how sitting around reduces the flow of blood, oxygen and nutrients to your brain.

High blood pressure is subtle. You can’t see it. You can’t feel it. You can’t hear it.

It can quietly damage the body for years before symptoms start showing.  And the harm it can do to your health is incredible. Heart attack, stroke, dementia, kidney damage and even sexual dysfunction.

But what really causes high hypertension?

It’s not just one thing, that’s for sure.

Nobody likes the feeling of an upset stomach. The nausea, vomiting, cramping and diarrhea are miserable.

And uggh! The thought of putting food into an already upset stomach sounds like a horrible idea. Just the smell of certain foods can make you feel queasy all over again.

Still, there are some foods and beverages that can provide a little nutrition – and even help soothe your unsettled stomach. This is true regardless of whether the issue is caused by something you’ve eaten previously, or if it’s due to a viral or bacterial infection.

Are knees that pop, creak, crunch or make grinding noises something you should be concerned about?

Well, the occasional crack or pop probably isn’t anything to worry about. In most cases, that’s just gasses being released from the joint.

But if one or both of your knees regularly makes rubbing, creaking and grinding sounds, it might be a symptom of inflammation and cartilage damage. It could also be a sign that you’ll start experiencing arthritic knee symptoms in as little as the next 12 months.

Up until a few years ago, most folks considered eggs off-limits. If they ate them at all, they separated out the whites, and threw the most nutritious part – the yolk – into the garbage disposal.

Well, now that eggs are off the hook when it comes to cholesterol and heart disease, you may be eating one or two of them a day – yolk and all.

This is great. The yolk is the part of the egg that’s highest in choline, which is an important brain food. If you don’t have enough of it, it can affect your memory and brain volume.

I use extra virgin olive oil (EVOO) in the majority of my meals. Not only does it have great flavor, it’s absolutely THE BEST choice for my health.

Unlike margarine, butter and other saturated fats, EVOO has medicinal properties that can reduce your risk of health issues and early death. I’m talking about things like heart conditions, cancer, neurodegenerative diseases and respiratory disease.

As a matter of fact, the American College of Cardiology suggests that replacing just over two teaspoons of margarine, butter, mayonnaise or dairy fat with olive oil each day is linked to up to a 34% lower risk of early death. So EVOO is the hands down winner.

Have you ever noticed that certain skin problems run in some families? Mom, Dad and the kids all seem to have the same sort of problems. Perhaps it’s life-long issues with psoriasis. Or maybe it’s eczema. There is a reason for this.

In particular, family members who grow up in the same household often follow the same eating habits.

Let’s say Mom and Dad grew up eating meat, dairy, white bread and sugary desserts at most of their meals. They end up feeding the same foods to their kids, and the kids pass the legacy on to the grandkids.

My father, brothers, and uncles all suffered from heart attacks. They also all had one strange physical sign – creased earlobes!

Believe it or not, this is a warning sign that your arteries may be at increased risk for clogging. And there are well over 50 studies to prove it. (Look for a crease that runs diagonally from the top of your earlobe to the lower edge of your earlobe.)

Earlobe creases form because of weakened then folded collagen in your ears. It’s also a sign of weakened collagen elsewhere…especially in your arteries. Once this symptom appears, it’s really important for you to take note.

Not long ago, four American families took part in a very revealing experiment. The families were from Atlanta, Baltimore, Minneapolis and Oakland, and each included two or three children.

For the first five days, the families ate their regular diets, which consisted of non-organic foods. These are the types of food that the average American eats.

For the next six days, the families continued to eat their regular diets with only one, single exception: all of the foods they ate were certified organic.

I’ve noticed an odd thing over the years.

When it comes to choosing something to drink besides water, a lot of folks have no idea what constitutes a healthy beverage.

For example, I’ve noticed that most of the “healthy” choices made by my patients include milk, juice and diet soda.

Last month I mentioned an interesting thing about music… how certain songs can transport you back in time to a specific moment that evokes a cherished memory.

Have you ever noticed that the same thing happens with certain scents and odors? It might be a whiff of perfume that suddenly brings an image of your mother; or maybe freshly mowed grass that produces the youthful memory of hot summer days spent outdoors playing with friends.

There are a lot of memories, emotions and feelings associated with our sense of smell. So it’s probably not surprising that people who have a poor sense of smell also tend to have worse memories.

My patients often ask me which type of alcohol is the “healthiest.” And they’re always disappointed in my answer.

There is no “healthy” alcohol.

“But doc,” they say. “Red wine protects your heart” … “Moderate drinking helps you live longer” …

I love hearing about older people who have defied the myth of old age.

One of my favorites is Ernestine Shepherd. When she was in her late 50’s, she looked and acted like we seem to think people approaching their 60’s should. She was overweight, had no interest in exercise, and had never worked out a day in her life.

But guess what happened?

You often hear that vitamins and other supplements are a waste of money… that following a diet with plenty of fruits and vegetables provides all the essential vitamins and minerals you need.

This is a nice concept in theory, but the fact is, only one out of every 10 adults eat the recommended daily servings of fruits and vegetables. This means 90% of Americans are eating less than the current guidelines of 1½ to 2 cups of fruit per day and 2 to 3 cups of vegetables.

In other words, the majority of Americans have significant nutrient gaps in their diet. And these deficiencies can lead directly to poor health.

So the idea that supplementation is a waste of money is absurd! This is especially wrongheaded (and short sighted) since the protective nutritional content of our food has decreased while the environmental and life stressors we experience have increased!

Back in 1988 a strange thing happened.

A hospital launched a “Healthy Eating Day.”

But shortly after enjoying the healthy lunch offered by the hospital, one of the surgical record-keepers fell ill. And before the end of the day, 10 more people who ate in the cafeteria experienced nausea, vomiting and diarrhea.

What was happening? How could a perfectly healthy meal make people sick?

When most people think of protein sources, their first thoughts generally run toward poultry, beef and other meat sources. Next on the list are things like eggs, milk and cheese; again from animal sources.

Plant-based protein sources, like nuts or beans are never high on the list. For most folks, they aren’t even on the list!

Well, guess what? It turns out that people who eat higher amounts of plant-based protein have a greater likelihood of healthy aging compared to those who get most of their protein from animal sources.

The topics my patients ask me about run the gamut.

But the one that always surprises me the most is when patients ask if it’s still okay to have sex. This question mostly comes from men who think they’re “too old” for bedroom activity or have a heart condition. (That doesn’t mean that a fair share of women don’t ask this question, too!)

For some reason, maybe due to television dramas, they imagine they’ll experience sudden cardiac arrest during these activities and die in the arms of their lover.

While this is certainly not the worst way to go, it’s an extremely unlikely outcome.

Do you run out of steam before the day ends, or maybe even before it starts?

If there isn’t an underlying health condition involved, there are a lot of different reasons this could happen. You might not be sleeping as well as you should. Maybe you’re not getting enough exercise. Stress can do it to you. So can dehydration.

But sometimes it’s the foods you’re eating. Or not eating.

Some people think it’s “normal” to grow weak, lose weight and start moving at a snail’s pace as we grow older. That it’s “normal” to lose your mental faculties and succumb to dementia.

If it’s so normal, then why are there so many active, healthy and engaged senior citizens out there?

Take Norman Lear, for example. Along with nearly everyone else in America, I was shocked and saddened by his recent death. He was 101 years old and still going strong before he died of cardiac arrest last month.

This television icon was extremely active and cognizant, even in “old age.”

Here’s a whopper of a statistic: Out of around 14 million US adults who have knee arthritis, it’s estimated that more than half of them will eventually require knee replacement surgery.

Now, going through knee replacement surgery isn’t a walk in the park (no pun intended). After surgery, you literally have to learn to walk again. And there will be a lot of physical therapy. Depending on your health, it could take several months to regain a normal gait and speed.

But here’s the thing…

Have you ever noticed that certain songs can transport you back in time? Back to a specific moment that evokes a cherished memory?

Or that you can hear a song on the radio that you haven’t listened to for 10 or 15 years and suddenly remember every word, note and nuance of it?

Some music is so familiar and upbeat that you can’t resist tapping your feet and bobbing your head every time you hear it, no matter where you are or what you’re feeling at the time.

And here is something that’s even more amazing.

Sleep is one of those things a lot of people don’t get enough of.

In our younger years, it just didn’t seem that important. We were too gung-ho to get as much done in a single day as we could. Who cared about sleep?

But as we age, the decision to sleep or not isn’t always our choice to make. You’ve probably experienced this more often than you did when you were younger. You want to sleep, but it evades you.

I don’t think people realize that herbal teas aren’t really tea, per say. Green and black teas all come from the same Camellia sinensis plant. The difference between them comes from green tea being steamed after the leaves are harvested. This prevents oxidation and increases levels of health boosting EGCG (Epigallocatechin).

Herbal teas, on the other hand, are made using the leaves, stems, roots, flowers, bark, seeds or petals of specific herbal plants. So they are more of an herbal infusion, even though we call them herbal teas.

And we’ve all used one or more of these herbal concoctions at some point in our lives.

Have you ever noticed that all drug commercials are basically same? The words might change. But in the end, all of them portray happy people and happy families.

TV ads for GLP-1 agonists are some of the worst. These are those drugs you see advertised on TV to support weight loss and help manage blood sugar levels. Some of the brand names include Trulicity, Byetta, Victoza, Rybelsus, Monjauro and Ozempic.

Most of the advertisements for these meds include a feel-good catchphrase or jingle. Some of them even contain subliminal messages. The Ozempic commercial is a perfect example of this.

People don’t comprehend the absolute unremitting pain of peripheral neuropathy. It begins with tingling in the feet, then moves on to a feeling of “pins and needles” or burning sensations like your feet are on fire. It can even feel as if you’re walking on clouds – like your feet aren’t touching the floor – because you can’t feel the floor.

But it’s not until the real pain starts that people begin to get upset. That’s when it starts interfering with daily activities, because it’s difficult to walk or remain standing for any length of time.

Left untreated, it could lead to numbness and a loss of feeling in the feet, which can severely affect your balance.

On December 14, 2023 the CDC announced that Flu and Covid cases had not yet reached their peaks this season. And sure enough, virus activity was on the rise during the last week of December. So we can expect to see this trend continue into January, maybe even February.

Your best defense against these types of viral infections is to ramp up your immune response, increase antiviral activity in your body for the duration, avoid sick people in general and, more specifically, steer clear of crowded and closed indoor spaces.

I like to ramp up my immune system with the foods I eat. In fact, years and years ago I created a great recipe for my own, natural, immune booster.

Are you still sold on the idea that whole wheat breads, cereals and pastas are your best sources of fiber and the answer to good health?

I’m not. And I’ll bet your reaction this statement is the same as many of my patients.

“What the heck, Doc,” they say. “Our ancestors ate grains all the time. What’s your problem?”

It’s not my problem. It’s everyone’s.

When I was in medical school, my classmates and I were all taught about Addison’s disease. That’s when the adrenal glands literally fail. We also learned about Cushing’s, a disease that occurs when you have too much cortisol and other hormones.

But the idea of adrenal fatigue itself was never a topic. And to this day, many doctors don’t understand it, let alone know how to diagnose it. In fact, the medical industry doesn’t actually even recognize it as a real medical condition.

On the other hand, this is something we’re seeing more and more of. Especially as the stressors associated with modern life continue to grow. These stressors consistently activate our “fight or flight” response, which lies at the root of adrenal fatigue.

To be honest, the safest water on the planet is probably found high in the Himalayan mountains — where glaciers are slowly melting away.

This water is crisp, clean, and untainted by any human chemicals.

But any natural water source that flows downhill will pick up toxins along the way.

Losing your eyesight is no joke. It’s the fastest way to lose independence as you age… you’ll lose your driver’s license… have trouble getting around… things that were once easy will become a struggle.

And one of the most devastating eye conditions today is age-related macular degeneration, or AMD. It’s the leading cause of blindness in people over 60 years of age.

But AMD isn’t something that happens overnight. It takes years of damage to your macula.

Well, it’s that time of year again. People are packing their bags and getting ready to hop on a flight to visit family and friends for the Christmas holiday. 

According to a survey conducted by The Vacationeer, a travel website, approximately 50% of U.S. adults are expected to travel for the holiday this year. So, in the coming days millions of Americans will be flooding to the airport; all of them hoping to avoid long delays and cancellations.

Holiday travel is always stressful. And if you are traveling across time zones, the fatigue, irritability and digestive issues that accompany jet lag can compound that stress… the last thing you need if you want to truly enjoy the festivities.

In many cases, small lapses in memory don’t mean a lot.  After all, most of us have experienced occasional memory blips throughout our lives.

From the youngest to the oldest of adults, we’ve all lost a remote control, missed a scheduled appointment or two, and forgotten to return any number of phone calls.

And who doesn’t forget what day it is every now and then?

Now that the holidays are in full swing, I’ll bet you’ll find yourself under a sprig of mistletoe a time or two over the next couple of weeks. You might even get a few pecks on the cheek.

But mistletoe isn’t just for kissing. It also shows great hope as a powerful weapon in the fight against cancer.

You don’t hear much about it here in the U.S. But over in Europe, mistletoe has been used to treat cancer since the 1920s. It’s even considered a routine treatment protocol in European hospitals. And cancer patients swear by it.

If you suffer from heartburn, acid reflux or other digestive complaints, it is incredibly easy to take an antacid drug in the hopes of gaining some relief. But if you start relying on these medications to consistently ease your symptoms, you could be making one of the biggest mistakes of your life.

In recent years, the safety of these meds – both over-the-counter and prescription – has been called into question. And with all of the evidence I’ve seen, I can honestly say that they present a clear and present danger when it comes to your health.

I’m talking about proton pump inhibitors, or PPI’s. Some of the popular brands that fall into this category include Nexium, Prilosec, Protonix and Prevacid… also known by their generic names; esomeprazole, omeprazole, lansoprazole and pantoprazole.

I’m past the traditional age of retirement. But I don’t see myself stopping work anytime soon.

I just enjoy talking with people about functional medicine too much. I love seeing my patients. And I take a great deal of pleasure attending training and educational opportunities – especially when I’m invited as a keynote speaker.

Plus, I’ve read the statistics on what happens to people when they work longer, and I really like them.

I recently had a patient diagnosed with rheumatoid arthritis (RA). She had joint pain and swelling in the fingers, wrists, elbows, shoulders, knees, ankles; everywhere!

When she came to see me, we did a comprehensive digestive stool analysis. This is a stool test that looks at a lot of things. This includes markers of digestion, absorption, sensitivities, inflammation and immune function.

The results of the test showed she was grossly inflamed, with a very high level of increased intestinal permeability – or leaky gut. It turns out she was sensitive to a lot of the foods she was eating, especially gluten.

Just a few days ago I informed you about the way low estrogen is a major cause of sexual health issues in postmenopausal women. Today, I would like to talk about estrogen from a male perspective.

As we men age, two hormonal changes of great consequence happen; testosterone levels decline and estrogen levels go up. Now, we hear plenty about testosterone. After all, it’s the “manly” hormone. Every man on earth wants more of it.

But we don’t hear nearly enough about estrogens. And these days, estrogens are a real problem when it comes to maintaining male virility. These excess estrogens are often the main cause of excess belly fat, loss of muscle strength and the development of breast tissue – often referred to as “man-boobs.”

When it comes to sexual health, we men are prone to experience problems with erectile dysfunction. Still, it seems to me that aging women have it a lot worse.

First, they have to suffer through the hot flashes and night sweats associated with menopause. This goes on for an average of about seven years, but can continue for as many as 14.

Then, they have to spend the remainder of their lives living with the consequences of the hormonal shifts that occurred during menopause. And it can really wreck their sex lives.

The holiday season is here, and over the next several weeks you’ll be invited to any number of gatherings. Chances are good that alcohol will be flowing pretty freely at these events. So even if you don’t normally indulge, you’ll probably find yourself with a drink in your hand on more than one occasion.

The fact is, more people overindulge in alcoholic beverages during the winter holidays than at any other time of the year. And it’s not hard to find yourself more than a little “tipsy” before you realize you’ve sipped one drink too many.

That’s because, depending on your weight, liver size and health, your body can only metabolize so much alcohol each hour. But when it catches up with you, it can hit like a sledgehammer.

Back in the 1960’s, obesity wasn’t much of a concern. It wasn’t even really an issue. After all, only a small portion of U.S. adults – about 13 out of every hundred – were dealing with extreme weight issues.

Today it’s an entirely different story. Around 43 out of every hundred adults are obese. Add on the number of people who are overweight, and it turns out that nearly 74% of American adults are struggling with their weight!

While there are a lot of factors involved in the obesity epidemic, one of the most important factors might just be the widespread availability (and yum factor!) of foods that have a high fructose content.

You already know that uncontrolled high blood pressure is bad for your heart.

It creates microscopic tears in the walls of your arteries. These tears eventually turn into rough scar tissue where sticky fats, plaques and cholesterol tend to accumulate. This, in turn, leads to blockages, narrowing of the arteries and arterial stiffness.

Once this occurs blood flow is reduced even further. And your heart has to pump harder and harder to get blood to all of your organs.

This means high blood pressure doesn’t just place your heart at risk.

Dieters often cringe at the mention of calorie restriction. And there is a reason why.

Most of them have already gone through the torture of nearly starving themselves for a few days, weeks or longer. They even got excited when they lost a few pounds.

Then, one of two things happened.

1. The gnawing hunger drove them crazy, so they stopped early in the game.
2. They were able to sustain the restricted diet, but hit a weight-loss plateau and gave up.

When people come into my office with unexplained aches, pains or numbness in one elbow or another, they often describe their condition as “tennis elbow.”

And in many cases, they’ve looked this term up on the internet to set their own treatment schedule, only to find that it’s not working.

The reason is pretty simple. Not all aches and pains of the elbow are the same. So if you’re treating yourself for tennis elbow, you may be aggravating another condition that’s actually causing your elbow pain.

Allowing your immune system to get rundown during flu season is like issuing an invitation for the flu to take up residence in your body.

Now, there are many reasons your immune function may be working sluggishly. Spending all your time indoors and a lack of physical activity are both linked with lowered immune function. A poor diet never does anyone any good. Stress, grief and depression will all run it down quickly.

And let’s not forget about the link between poor sleep, reduced immune function and the flu.

In the October 16, 2023 issue of Advanced Natural Wellness you learned the warning signs of a heart attack or impending cardiac arrest.

But how do you tell these apart from a stroke?

Well, there are a lot of misconceptions about strokes. Many people believe they are very similar to a cardiac event. While both are related to vascular issues, that’s where the similarities begin and end.

Here is an odd and random statistic…

COPD is third highest cause of death here in the U.S., following right on the heels of heart disease and cancer. This means more people die from chronic respiratory disease each year than from stroke, Alzheimer’s, diabetes or influenza.

So I find it strange that people aren’t talking about it.

My new patients are often surprised when I don’t approach their health concerns in the way they expect.

For instance, I once had a 50-year-old woman visit my office with awful joint pain. She was morbidly obese with pain in her fingers, knuckles, wrists, shoulders, knees and hips.

A bone scan ordered by her conventional rheumatologist showed systemic inflammatory illness in her joints.

Pretty much everyone knows that if an artery gets clogged it can trigger a heart attack. What many people may not realize is that heart attack symptoms often differ between men and women.

Sure, classic symptoms such as chest pain are common in both sexes. But women are much more likely to have less common symptoms such as fatigue, shortness of breath, a feeling of indigestion or back pain – without any chest discomfort at all.

This can lead to problems getting a proper diagnosis for women. It’s something I remember from the days when I was in training.

Salt intake is quite a dilemma these days. On one hand, your body needs sodium to transmit nerve impulses, help your muscle’s function and maintain fluid balance.

But when you get too much of it, it accumulates in the bloodstream where it attracts water. When this happens it increases blood pressure, which can damage your blood vessels and increase the workload on your heart.

And the truth is, most folks are getting a lot more sodium than they need these days – sometimes without even realizing it.

So many in the medical community have dismissed the use of supplements as a tool for better health. Their logic is about as simple as it gets: If you eat a healthy diet, you’ll get all of the nutrition you need.

Well, a June 2023 study out of Oregon State University says just the opposite.

When a group of men age 68 and older took either a multivitamin or placebo, the results spoke for themselves.

When men think of prostate problems, they immediately think of urinary difficulties.

After all, that’s what we all hear about… dribbling over the toilet in the middle of the night. Road trips postponed and ball games cut short because of the “urge to go.”

But there’s another side of the story that is equally disturbing:

Everybody knows that a high sodium intake, excess weight and lack of physical activity are all bad for their blood pressure, right? It’s because we talk about these key contributors to hypertension all of the time. But what about the ones that we seldom hear about?

For example, did you know that when you are dehydrated, it causes your blood pressure to increase? Part of the reason is due to the fact that dehydration causes the body to retain more sodium. And, as we all know, higher sodium levels are directly related to hypertension.

At the same time, dehydration causes your body to release more vasopressin than it normally would. This chemical causes blood vessels to constrict, which makes your blood pressure rise.

In the September 25, 2023 issue of Advanced Natural Wellness, I mentioned how much I love to put on some music and bop around the house while I’m doing chores.

I do the same thing when I’m ready for some more purposeful physical activity.

For example, I love listening to the Eurythmics “Sweet Dreams” when I’m walking on a treadmill. With the speed set at 3.5 miles per hour, I find it’s the perfect tune to give a bounce to my step and a boost to my brain.

Sometimes it seems like the older we get, the lazier we become.

Instead of taking the stairs we are happy to ride the elevator – even if it’s going to take us longer. It’s easier to go through a drive-up window than get out of the car and walk indoors; or to drive the quarter mile to the coffee shop instead of walking.

Today’s technology has made it even worse. If you don’t feel like shopping, Instacart or Walmart Delivery will be happy to deliver groceries to your front door. If cooking sounds like too much work, DoorDash, Uber Eats and other delivery services are happy to bring the meal of your choice to your home.

Everybody needs to get nutrient rich vegetables in their diets. It doesn’t matter which dietary lifestyle you’re operating on. Whether it’s omnivorous, carnivorous, vegetarian or vegan, you still need to have your vegetables.

So why not eat the ones that have the most nutritional value?  

You see, some plant-based foods are more nutritionally dense than others. We give them a score, called the “nutritional density score,” based on the balance of vitamins, minerals, antioxidants and fiber in them.

Everyone wants to protect their heart health, and taking low-dose aspirin sounds like an inexpensive way to do that. After all, what harm could come from taking an over-the-counter pill that was originally formulated for children?

Well, the fact is that low-dose aspirin is so dangerous that, if a company attempted to bring it to market today, it would never make it. It just wouldn’t pass scrutiny.

That’s because the evidence of horrible side-effects with daily use is overwhelming.

Your feet are your body’s foundation. And they’re awesome.

Believe it or not, each foot accounts for about 1.5% or less of your bodyweight. Yet they carry the entire weight of your body around for an entire lifetime. More than that, really. Because when you walk, the pressure on your heels and the front of your feet can be more the double your body weight.

And here’s an amazing little tidbit for you. If you walk 7,500 steps a day, by the end of your life you will have walked the equivalent of about five times around the Earth.

If you suffer from knee osteoarthritis, there are a lot of common treatments that don’t work well, and an equally long list of alternative treatments that do.

So today I’m going to make things extremely easy for you.

First, we will take a look at what doesn’t work to ease knee pain. Then, I’ll clearly explain what does.

Type 2 diabetes is a real epidemic these days, and it comes with all sorts of health problems. It puts you at two to four times the chance of heart disease or a stroke. It affects your brain function, damages your nerves and causes kidney problems.

The one thing many people don’t realize is that type 2 diabetes is largely preventable. This is true even in people who are genetically susceptible to the disease.

As a matter of fact, a large study recently discovered that poor diet has been tied to more than 70 percent of new type 2 diabetes cases worldwide. That’s a huge number!

Alzheimer’s disease and dementia are top concerns for my aging patients. Many of them lost one or both of their parents to the disease. Some have lost a grandparent or two to it.

If you’ve experienced this type of loss, you might feel like you have a target on your back… that you’re next in line.

Well I’ll tell you the truth. While you may be at higher genetic risk of the disease, it doesn’t necessarily mean you are a prime candidate for it. I always explain to my patient that it’s not genetics that count the most… it’s how you live your life.

I eat a lot of fruits and vegetables to support my heart health.

In fact, one of my favorite kinds of green smoothies is filled to the brim with fruits and vegetables. I start with some honey and nut milk followed by a generous bunch of dark-leafy green vegetables like spinach or romaine.

Then, I’ll add in some blueberries or a frozen banana and top it off with a heaping teaspoonful of ground flaxseed and some organic almond or cashew butter. Then, I’ll blend it until it’s smooth and creamy.

Everyone “gets” the idea of taking a multi-vitamin, minerals and many other supplements to help offset nutritional deficits.

But what about CoQ10?

CoQ10 is one of those nutrients everyone over the age of 40 needs more of. It’s also one that’s least understood by most folks.

It’s not a vitamin. It’s not a mineral. So what is it and why do you need it?

It seems like every new decade comes with its own set of health issues.

When I turned 30, I got out of bed and my ankles cracked. When I turned 40, my knees cracked. And when I turned 50, my back cracked…

By the time I turned 60, I just hid under my covers and didn’t get up. (Just kidding!)

In all honesty, heading into your 60’s and 70’s can be intimidating. These ages come with a stigma attached to them that you’re past your prime.

You feel sort of like an old piece of food that came from the grocery store – one with a “use by” date that is fast approaching.

One thing that drives me absolutely crazy is ambient light in my bedroom when I’m trying to sleep. I leave my phone in my office, cover up all of those blue, green and red lights from power strips and other equipment, and use black out shades on my windows. Otherwise, I can’t sleep at all.

There is a reason those lights affect my sleep. They may be affecting yours too, and you might not even be aware of it.

You see, in the absence of light, our brains produce melatonin, our main “sleep hormone.” But when we are exposed to light at nighttime – even low levels of it – melatonin production is halted.

I once had an 87-year-old patient who gave me his recipe for a drink he called “Blood.”

Now, before you get too grossed out, let me explain…

Yes, his bright red juice looked a lot like blood. But this name was appropriate for another reason.

The superstar of his drink was beetroot juice – an ingredient that can actually boost blood flow throughout your entire body.

Just one glass of beetroot juice a day can help protect your heart and brain, boost your stamina, and ease your aching joints all day long.

I’ve been using a water pic for about the past three months. And on my most recent dental cleaning, the hygienist at my dentist’s office was amazed. I had no plaque!

They wondered what I had been doing, and I explained that I had added the water pic to my daily dental routine.

It acts like dental floss, except that it uses a jet of water to irrigate all of those tight spaces and crevices between your teeth and at your gumline. That means it can flush plaque and bacteria out of the periodontal pockets under your gumline where it gathers and can lead to infection.

All across the U.S. – from California to Louisiana and South Florida – record high temperatures are being broken. Not only that, but power grids are being stretched to their limits trying to keep millions of air-conditioners running.

So the first order of business is to try and stay as cool as possible.

If you’re stuck at home without A/C or if the power is out, a couple of cool, wet cloths can work magic, so keep a few on hand. You can wrap them around your neck, wrists or ankles to help cool you down. Sink into a tub of cool water or take a cold shower during the hottest part of the day for a full body cool-down.

By the time we men hit our 30s, our testosterone levels naturally start declining. But over the past several decades, testosterone levels in the U.S. have been dropping more quickly than they did 30 years ago. 

Since the late 1980’s, average levels of testosterone in men dropped by one percent each year. So a 65-year-old man in 2021 would have levels 30% lower than a 65-year-old man in 1991. These decreases don’t appear to be associated with lifestyle, so why the big decline?

Well, these days estrogen mimics, called xenoestrogens, are all over the place. These fake estrogens attach to certain cell receptor sites and displace testosterone. Over time they build up in your system and exert estrogen dominance in men. And you can find them almost everywhere.

We’ve always lived with blue light from the sun. Now we’re getting it from our electronic screens too. So we’re exposed to a lot more blue light than we used be.

And it’s crazy how much time people are spending on their phones these days! Depending on which poll you read, people are averaging anywhere from 3.25 hours to 5.7 hours each day on their smartphones…every day.

Do the math and that adds up to between 53 and 86 days a year on their phones.